Wagga Tri Club - Winter Series (3 of 3)

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Who are you registering? Choose one Yourself Someone else Team

Team name   First name   Last name   Email address   Age on event date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 Gender -- Male Female Female/Male   Are you a member of TA ? Choose one Yes No Other     TA membership number - if applicable Other     Emergency contact name Emergency phone # Category Choose one Enticer (14+ years) Junior (9-13 years) Open (14+ years) Sub Junior (5-9 years) Team-Enticer (14+ years) Team-Junior (9-13 years) Team-Open (14+ years) Team-Sub Jnr (5-9 years)

Team member name #1  *   Team member name #2  *   Team member name #3 Name of person registering team  *   Are you 18 or over ?  * NoYes   Would you like to be notified about future Wagga Triathlon Club events ? NoYes

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver Declaration: I declare that I am medically fit, will abide by the event rules, and will in no way hold the organisers or sponsors responsible for any injury, illness or accident to my person or loss of property resulting from my participation in this event. I acknowledge that the Wagga Triathlon Club plan to capture and use photographs from this event in printed and electronic media. An example is the club's Facebook page. I authorise the use of these photos of me and for those of whom I am a guardian. I accept the terms of the Wagga Tri Club - Winter Series Name of Parent/Guardian for under 18 years Please enter your initials here.